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CNS sarcoidosis: evaluation with contrast-enhanced MR imaging
S Seltzer1, A S Mark, S W Atlas
1Department of Radiology, George Washington University Medical Center, Washington, DC 20037.
AJNR. American Journal of Neuroradiology
|November 1, 1991
Summary
Contrast-enhanced MRI significantly improves the detection of neurosarcoidosis, especially meningeal involvement. Unenhanced scans may miss crucial signs of central nervous system (CNS) sarcoidosis.
Area of Science:
- Neurology
- Radiology
- Immunology
Background:
- Neurosarcoidosis, a rare inflammatory disease, frequently involves the meninges.
- Unenhanced MRI may underestimate the extent of meningeal sarcoidosis.
Purpose of the Study:
- To evaluate the diagnostic utility of contrast-enhanced MRI in detecting neurosarcoidosis.
- To compare unenhanced and contrast-enhanced MRI findings in patients with neurosarcoidosis.
Main Methods:
- Retrospective study of 14 patients with confirmed neurosarcoidosis.
- Analysis of T1- and T2-weighted pre- and postcontrast MRI sequences.
- Comparison of findings on unenhanced versus contrast-enhanced scans.
Main Results:
- Meningeal involvement was missed on unenhanced scans in 8 of 12 intracranial and 1 of 2 spinal cases.
- Contrast enhancement revealed meningeal disease in patients where it was not apparent on unenhanced images.
- Enhancing extraaxial masses mimicking meningiomas were observed.
- CNS findings were the initial presentation in 5 of 14 patients.
- Diagnosis was suggested only after contrast administration in 9 of 14 patients.
Conclusions:
- Gadopentetate dimeglumine-enhanced MRI significantly increases sensitivity for detecting CNS sarcoidosis.
- Contrast-enhanced MRI is crucial for accurate diagnosis and assessment of meningeal involvement in neurosarcoidosis.